A comprehensive guide to ear wax management for parents and caregivers

Written by: Dr Margarita Burmester
Edited by: Conor Dunworth

In her latest online article, leading consultant paediatric specialist Dr Margarita Burmester offers a comprehensive guide to ear wax management for parents and caregivers. She explains the different types available, and which is best for your child.


Dealing with Ear Wax Buildup: Tips for Parents and Caregivers

Managing ear wax accumulation in children can pose a challenge for parents and caregivers, potentially leading to discomfort, impaired hearing, and even infections. However, it's important to note that sometimes ear wax in children naturally dislodges without any intervention. In this article, we will explore effective methods to manage ear wax, including the use of drops and sprays, providing essential information for parents and caregivers.


Understanding the Importance of Ear Wax Management

Ear drops serve as a common solution for softening and removing ear wax. Various types of ear drops are available, such as olive oil and sodium bicarbonate drops. Nonetheless, it's crucial to adhere to the guidance provided by healthcare professionals and to administer drops only when recommended.


It's equally vital to understand when not to employ drops. If there's suspicion of a perforated eardrum in your child, refraining from using drops or sprays is imperative. Similarly, sodium bicarbonate drops should be avoided if your child has grommets.


Choosing the Right Drops

When selecting the appropriate ear drops, olive oil proves to be a valuable option for long-term use and recurrent wax concerns. Olive oil effectively softens the wax without dissolving it. In contrast, sodium bicarbonate drops actively dissolve wax, offering a faster and more efficient method of wax removal. These drops are readily available at pharmacies and should only be used for a duration of 7-10 days.


Proper Application of Drops

Administering drops in your child's ears involves warming them to body temperature and positioning the child on their side with the treated ear facing upward. For sodium bicarbonate drops, follow the prescribed dosage and place the drops in the ear. In the case of olive oil, a few drops can be introduced into the ear canal. Encouraging your child to remain on their side for around 5 minutes allows the drops to penetrate effectively.

It's important to note that a decrease in hearing or peculiar sounds like popping might be reported by your child during this process. These sensations arise as the drops take effect. To prevent the drops from escaping, placing a temporary cotton wool barrier within the ear can be beneficial. If both ears require treatment, a 30-minute interval between treatments is recommended.


Guidelines for Drop Usage

The frequency of drop administration depends on the chosen type. For olive oil, daily usage is recommended to gradually soften the wax. Following this, a weekly application suffices until the child's subsequent review appointment. Conversely, sodium bicarbonate drops should be used for 7-10 days post the initial appointment, with another round of application 7-10 days before the next review.


Monitoring and Seeking Professional Help

Should your child experience discomfort or pain during drop usage, discontinuation is crucial, followed by a consultation with a healthcare professional. Persistent ear pain or discharge should also prompt seeking medical advice before attempting any wax management techniques. In some instances, ear wax accumulation might indicate an underlying medical condition, underscoring the importance of professional consultation to ensure appropriate treatment.


Olive Oil Spray Option

An alternative to traditional drops is the use of an olive oil spray, obtainable from local pharmacies or supermarkets. This method guarantees the safe, easy, and accurate application of olive oil. Additionally, it eliminates the need for the child to remain still post-application. However, it's imperative not to insert cotton wool into the child's ears after using the spray, and refrain from using olive oil spray if a perforated eardrum is suspected.


Effectively managing ear wax buildup in children involves understanding the right techniques and seeking proper guidance. If you're concerned about your child's ear wax, always consult a healthcare professional for advice. Should your child experience pain or discomfort, discontinuing drops or spray usage and consulting a healthcare professional is recommended. By following these guidelines, you can ensure your child's ear health is managed with care and precision.


Dr Margarita Burmester is a highly regarded consultant paediatric specialist based in London. If you would like to book a consultation with Dr Burmester, you can do so today via her Top Doctors profile.

By Dr Margarita Burmester

Dr Margarita Burmester is a leading consultant paediatric specialist based in London with over 30 years’ experience who is trained in all aspects of paediatrics. This includes preventative paediatric care, general paediatric care, paediatric cardiac intensive care and paediatric critical care, as well as child development, child health education, infant colic, and health screening and surveillance.

With a passion for preventing ill health, Dr Burmester is the co-founder and director of the renowned The Bright Futures Health™ programme, an extensive all-encompassing health surveillance and screening programme for families based on the American Academy of Pediatrics model. This programme is currently available at 77 Wimpole Street and at the Chiswick Medical Centre, where Dr Burmester consults privately, offering paediatric care, child health surveillance, and health check-ups.

Dr Burmester qualified from St Thomas’ Hospital Medical School, University of London, in 1989. Since then, she has worked in Canada at the Toronto Hospital for Sick Children, in the USA at Boston Children’s Hospital, Harvard University, and in London at Great Ormond Street Hospital. Dr Burmester was awarded her postgraduate certification in clinical education from King’s College University London in 2016, and has been both a Fellow of the Higher Education Authority and a Member of the Academy of Medical Educators.

In addition to her dedicated private practice, Dr Burmester has been a consultant paediatric intensivist at the Royal Brompton Hospital, London since 2002, where she was director of paediatric intensive care from 2009-2023. In 2008, Dr Burmester founded the multiple prize winning patient-safety educational SPRinT (Simulated Interprofessional Team Training) programme at Royal Brompton Hospital, with the objective of enhancing patient care.

Dr Burmester was the president of the Paediatrics and Child Health section of the Royal Society of Medicine from 2018 to 2021, and is a senior lecturer at the National Heart and Lung Institute. She has authored multiple publications, presented at numerous lectures, and has developed patented tools for patient care improvement. Dr Burmester's clinical performance has been recognised nationally through receiving the silver clinical excellence award given to the top 1.8% of all consultants, and she is a co-recipient of a prestigious Wellcome Trust Award.

Following her many quality improvement initiatives, Dr Burmester has been appointed “Q” fellow by the Health Foundation UK. As paediatrician and mother of three children, Dr Burmester is passionate about prioritising children's futures and understands the importance of maximising children’s health so that they can look forward to the brightest possible future.

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